What STD screening is recommended for a 16-year-old?

STD Screening Recommendations for 16-Year-Olds

All sexually active 16-year-olds should be screened annually for chlamydia and gonorrhea, with females requiring routine screening regardless of reported risk factors and males requiring screening based on risk factors and in high-prevalence settings. 1, 2

Core Screening Recommendations by Gender

For Females (16 years old)

• Chlamydia: Annual screening for all sexually active females ≤25 years 1, 2
• Gonorrhea: Annual screening for all sexually active females ≤25 years 1, 2
• HIV: Screen if engaging in high-risk sexual behavior 1, 2
• Syphilis: Screen if engaging in high-risk sexual behavior 1
• Trichomoniasis: Not recommended for routine screening unless high-risk factors present 1

For Males (16 years old)

• Chlamydia: Annual screening recommended for sexually active males, particularly in high-prevalence settings (≥2% prevalence) 1, 2
• Gonorrhea: Annual screening recommended for sexually active males, particularly in high-prevalence settings (≥2% prevalence) 1, 2
• HIV: Screen if engaging in high-risk sexual behavior 1, 2
• Syphilis: Screen if engaging in high-risk sexual behavior 1

Special Considerations for MSM (Men who have Sex with Men)

• Screen for pharyngeal, rectal, and urethral gonorrhea annually if engaging in receptive oral/anal or insertive intercourse 1
• Screen for chlamydia at relevant anatomic sites based on sexual practices 1, 2
• More frequent screening (every 3-6 months) if high-risk behaviors present 1, 2
• Annual syphilis screening, or every 3-6 months if high-risk 1

Testing Methods

• Urine NAAT (nucleic acid amplification test) is preferred for chlamydia and gonorrhea screening 2
• Pharyngeal testing for those engaging in receptive oral sex 2
• Rectal testing for those engaging in receptive anal intercourse 2
• Serum testing for HIV and syphilis screening 2

Rescreening Recommendations

• Rescreen all adolescents diagnosed with chlamydia or gonorrhea 3 months after treatment, regardless of whether partners were treated 1, 2
• If 3-month rescreening isn't possible, retest at next healthcare visit within 12 months 1

Risk Factors Requiring More Intensive Screening

• Multiple or anonymous sexual partners
• Inconsistent condom use
• Sex under the influence of drugs/alcohol
• History of previous STIs
• Sex in exchange for money or drugs
• Injection drug use
• MSM status with multiple partners

Common Pitfalls to Avoid

1. Missing asymptomatic infections: Most STIs in adolescents are asymptomatic but can lead to serious long-term complications if untreated 3
2. Failing to rescreen after treatment: High reinfection rates make the 3-month post-treatment test critical 1, 2
3. Overlooking anatomic site-specific testing: Testing should be guided by sexual practices (oral, anal, vaginal) 1, 2
4. Neglecting to screen males: While female screening is emphasized in guidelines, sexually active adolescent males also require appropriate screening 1
5. Forgetting to consider local prevalence: Local STI prevalence rates should influence screening decisions, especially for males 1

Additional Preventive Measures

• Verify hepatitis B vaccination status and offer if not previously completed 2
• Consider hepatitis C screening if additional risk factors present 2
• HPV vaccination is recommended through age 21 for males and age 26 for females 2

Implementing these evidence-based screening recommendations can significantly reduce STI-related morbidity in this vulnerable age group.